Efeito terapêutico do "cross-linking" corneano na ceratopatia bolhosa sintomática

Gadelha, Diego Nery Benevides; Bravo-Filho, Vasco; Júnior, Newton Andrade; Batista, Neylane N.; Escarião, Ana Cecília de Sousa Leão; Urbano, Roberta Ventura

doi:10.1590/s0004-27492009000400007

Cited by 15 publications

(12 citation statements)

References 16 publications

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“…However, the follow-up period in the Gadelha et al ,8 study was short (2 months) and similar to our study, they also found no significant improvement in VA or a decrease in CCT after 2 months.…”

Section: Discussionsupporting

confidence: 89%

“…Studies reporting the use of C3R to treat bullous keratopathy are rare 6–8. To date, our study is the largest case study and has the longest follow-up time in English peer-reviewed literature.…”

Section: Discussionmentioning

confidence: 94%

“…A previous study8 evaluated the therapeutic effect of C3R on the symptoms of bullous keratopathy and indicated that there are likely benefits to using C3R to treat the symptoms of bullous keratopathy. However, the follow-up period in the Gadelha et al ,8 study was short (2 months) and similar to our study, they also found no significant improvement in VA or a decrease in CCT after 2 months.…”

Section: Discussionmentioning

confidence: 99%

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The effects of riboflavin/ultraviolet: A corneal cross-linking on the signs and symptoms of bullous keratopathy

Gharaee

Ansari-Astaneh

Armanfar

2011

Middle East Afr J Ophthalmol

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Purpose:To evaluate the effectiveness of corneal cross-linking in improving the signs and symptoms of bullous keratopathy.Materials and Methods:This prospective non-randomized case series evaluated 20 eyes with bullous ketratopathy that underwent corneal cross-linking (C3R) with riboflavin and ultraviolet-A (UVA, 370 nm, 3 mW/cm2). C3R was performed for 30 min in a routine procedure after removal of epithelium. Central corneal thickness (CCT), corneal haze, visual acuity (VA), and the presence of irritating symptoms were recorded before the procedure, and at 1 week, 1 months, 3 months, and 6 months after the procedure.Results:The mean CCT was 872 ± 162 μm (range: 665-1180 μm) before the procedure. Following the procedure, CCT was 855 ± 175 μm after 1 week, 839 ± 210 μm after 1 month, 866 ± 185 μm after 3 months, and 863 ± 177 μm after 6 months (P>0.05, all visits). There was no significant improvement in VA or corneal clarity after 6 months. Improvement of the following symptoms: burning, pain, and foreign body sensation were reported after 6 months by 83.3%, 75.0%, and 66.7% of patients, respectively. Persistent epithelial defect occurred in five patients (25%) resolved with frequent lubrication and bandage contact lenses.Conclusion:The outcomes of this study indicate corneal cross-linking is not an effective treatment for bullous keratopathy with respect to VA and CCT, although it can improve irritation and discomfort.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

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The effects of riboflavin/ultraviolet: A corneal cross-linking on the signs and symptoms of bullous keratopathy

Gharaee

Ansari-Astaneh

Armanfar

2011

Middle East Afr J Ophthalmol

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“…In initial studies, CXL using the standard protocol has been shown to have a transient beneficial effect on vision, corneal thickness, clarity, and pain scores [ 1 , 4 – 6 ]. To improve the outcome of the procedure, Wollensak et al [ 3 ] performed CXL following dehydration with glucose 40% eye drops (three times daily) one day prior to surgery in 3 eyes of 3 patients and reported improvement in bullous changes, pain sensation, and CCT at the end of 8 months.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Two Corneal Collagen Crosslinking Methods in Bullous Keratopathy due to Fuchs’ Endothelial Dystrophy

Uçakhan

Sağlık

2014

Case Reports in Medicine

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Four eyes of 2 patients with corneal edema due to Fuchs' endothelial dystrophy were treated with CXL using the standard protocol. Since no improvement in visual acuity, corneal clarity, thickness, or pain sensation was evident in any eye at month 12, 2 eyes of the 2 patients were retreated, this time, following intraoperative corneal dehydration with glycerol 70% drops. This retreatment also failed to produce any significant effect on vision, corneal clarity, thickness, or pain in either eye. Collagen crosslinking with the current protocols may not be effective in the management of eyes with corneal edema due to Fuchs' endothelial dystrophy. Further studies are required to establish the efficacy of CXL and optimize the technique and/or dehydration method utilized in these cases.

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“…Таким образом, в опубликованных статьях представлены разные клинические данные об эффективности ККР в лечении ЭДР [22][23][24], поэтому остается спорным вопрос об эффективности ККР в лечении этих заболеваний [25][26][27].…”

Section: Introductionunclassified

Еvaluate the Effectiveness of Accelerated Collagen Crosslinking in the Treatment of Corneal Endothelial Decompensation

et al. 2020

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The article discusses the effectiveness of accelerated collagen crosslinking in the treatment of patients with corneal diseases, a common basic pathogenetic link of which is endothelial corneal decompensation. This method was used to treat patients with bullous keratopathy and endothelial dystrophy of Fuchs’ cornea with a long postoperative follow-up. In connection with the controversial results of researchers, reflecting the positive dynamics of the postoperative period, the question of the expediency of accelerated collagen cross-linking in patients with this pathology as a monotherapy is discussed.The study included 25 patients (26 eyes) with mean age 69.10 ± 10.61 years (40 to 82 years). There was Fuchs corneal endothelial dystrophy in 16 patients (17 eyes), in 9 patients (10 eyes) — stage II, in 7 patients (7 eyes) — stage III. Bullous keratopathy was present in 9 patients (9 eyes). All patients underwent treatment according to the method of accelerated collagen corneal crosslinking. In patients with bullous keratopathy (9 eyes), the data on the central thickness of the cornea and the maximum corrected visual acuity did not differ from the initial data at any of the postoperative visits, and did not differ from each other (p > 0.83). On the contrary, in some patients the dystrophic process progressed in the form of the appearance of fibrotic changes in the stroma of the cornea. Corneal transplantation was recommended to all patients under observation after treatment at different periods of observation. In patients with Fuchs endothelial dystrophy, a significant difference in the maximum corrected visual acuity from the initial data was observed only 6 months after surgery.The expediency of accelerated collagen cross-linking in the treatment of patients with corneal diseases accompanied by endothelial decompensation as monotherapy is very doubtful. The study of combined surgical methods for treating this complex corneal pathology using cross-linking as an auxiliary method seems promising.

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Efeito terapêutico do "cross-linking" corneano na ceratopatia bolhosa sintomática

Cited by 15 publications

References 16 publications

The effects of riboflavin/ultraviolet: A corneal cross-linking on the signs and symptoms of bullous keratopathy

The effects of riboflavin/ultraviolet: A corneal cross-linking on the signs and symptoms of bullous keratopathy

Outcome of Two Corneal Collagen Crosslinking Methods in Bullous Keratopathy due to Fuchs’ Endothelial Dystrophy

Еvaluate the Effectiveness of Accelerated Collagen Crosslinking in the Treatment of Corneal Endothelial Decompensation

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